O'Shea Michele S, Rosenberg Nora E, Hosseinipour Mina C, Stuart Gretchen S, Miller William C, Kaliti Stephen M, Mwale Mwawi, Bonongwe Phylos P, Tang Jennifer H
a The University of North Carolina Project-Malawi , Lilongwe , Malawi.
AIDS Care. 2015;27(4):489-98. doi: 10.1080/09540121.2014.972323. Epub 2014 Nov 4.
The objectives of this study were to describe the most recent pregnancy intentions and family planning preferences of HIV-infected and HIV-uninfected postpartum Malawian women, and to assess whether HIV status is associated with fertility desire and knowledge of intrauterine contraception (IUC) and the subdermal contraceptive implant. We conducted a cross-sectional analysis of the baseline characteristics of Malawian women enrolled in a prospective cohort study assessing postpartum contraceptive uptake and continuation. Women at a government hospital completed a baseline survey assessing reproductive history, family planning preferences, and knowledge of IUC and the implant. We used Pearson's chi-square tests to compare these parameters between HIV-infected and HIV-uninfected women. Modified Poisson regression was performed to assess the association between HIV status and fertility desire and knowledge about IUC and the implant. Of 634 postpartum women surveyed, HIV-infected women were more likely to report their most recent pregnancy was unintended (49% vs. 37%, p = 0.004). Nearly all women (97%) did not want a child in the next 2 years, but HIV-infected women were more likely to desire no more children (adjusted prevalence ratio [PR]: 1.59; 95% confidence interval [CI]: 1.33, 1.89). HIV-infected women were also less likely to know that IUC (adjusted PR: 0.72; 95% CI: 0.61, 0.84) and the implant (adjusted PR: 0.83; 95% CI: 0.75, 0.92) are safe during breast-feeding. Postpartum women strongly desire family spacing and many HIV-infected postpartum women desire no more children, suggesting an important role for these long-acting methods. Education about the efficacy and safety of IUC and the implant particularly during breast-feeding may facilitate postpartum use.
本研究的目的是描述感染艾滋病毒和未感染艾滋病毒的马拉维产后妇女最近的怀孕意愿和计划生育偏好，并评估艾滋病毒感染状况是否与生育意愿以及宫内节育器（IUC）和皮下避孕植入物的知识相关。我们对参加一项评估产后避孕措施采用和持续情况的前瞻性队列研究的马拉维妇女的基线特征进行了横断面分析。在一家政府医院的妇女完成了一项基线调查，评估生殖史、计划生育偏好以及对宫内节育器和植入物的了解。我们使用Pearson卡方检验来比较感染艾滋病毒和未感染艾滋病毒的妇女之间的这些参数。进行了修正泊松回归分析，以评估艾滋病毒感染状况与生育意愿以及关于宫内节育器和植入物的知识之间的关联。在接受调查的634名产后妇女中，感染艾滋病毒的妇女更有可能报告她们最近的怀孕是意外怀孕（49%对37%，p = 0.004）。几乎所有妇女（97%）在未来两年内都不想生孩子，但感染艾滋病毒的妇女更有可能希望不再生育（调整后的患病率比[PR]：1.59；95%置信区间[CI]：1.33，1.89）。感染艾滋病毒的妇女也不太可能知道宫内节育器（调整后的PR：0.72；95%CI：0.61，0.84）和植入物（调整后的PR：0.83；95%CI：0.75，0.92）在母乳喂养期间是安全的。产后妇女强烈希望间隔生育，许多感染艾滋病毒的产后妇女希望不再生育，这表明这些长效方法具有重要作用。关于宫内节育器和植入物的有效性和安全性的教育，特别是在母乳喂养期间，可能会促进产后使用。
